Ectopic Pregnancy Treatment

Prompt treatment of an ectopic pregnancy is needed to protect the health of the pregnant woman.

In all but very rare cases, an ectopic pregnancy is not viable, meaning it cannot result in a healthy baby.

In addition, most ectopic pregnancies represent a serious threat to the pregnant woman's health.

If a woman's body does not expel or reabsorb the embryo on its own, medical or surgical intervention is almost always necessary to end the pregnancy.

Watchful Waiting

If an ectopic pregnancy is caught very early, a doctor may elect to wait and see if the woman's body expels or reabsorbs the pregnancy on its own.

This approach is only recommended if the woman has no symptoms, such as abdominal pain or vaginal bleeding, and declining blood levels of the hormone human chorionic gonadotropin (hCG), which would indicate the pregnancy may be ending on its own.

Methotrexate

Another possible treatment option for an ectopic pregnancy that is caught early is the drug methotrexate (Trexall), which is also used to treat some forms of cancer as well as severe psoriasis and rheumatoid arthritis.

For treatment of an ectopic pregnancy, the drug may be given as a single injection or as multiple injections. Methotrexate interrupts cell division, preventing the embryo from developing any further.

Methotrexate is not a safe option for women who are breastfeeding and wish to continue doing so.

Within two to three days of injection with methotrexate, a woman can expect to experience increased abdominal pain that lasts for 24 to 48 hours, and vaginal bleeding or spotting.

Severe abdominal pain and heavy vaginal bleeding are signs of a ruptured fallopian tube and should be reported immediately to your doctor.

Other side effects of methotrexate can include nausea, vomiting, diarrhea, stomach upset, inflammation of the mouth and lips, and dizziness.

Following an injection of methotrexate, a woman must return to her medical provider's office several times for blood tests to measure her hCG level.

Falling hCG levels indicate that the pregnancy is ending.

Stable or rising levels indicate that further treatment is necessary, either with another injection of methotrexate or with surgery.

Surgery

If taking methotrexate is not an option or isn't working, the embryo must be removed surgically.

A variety of surgical techniques and approaches can be used, depending on where the embryo is implanted and, if it is implanted in a fallopian tube, whether the tube has ruptured.

Laparoscopy, surgery using very small instruments, inserted into the body through small incisions, is often the preferred approach.

It's less painful and requires less healing time than laparotomy, which involves an abdominal incision.

If the fallopian tube has not ruptured, it may be possible to remove the embryo while preserving the fallopian tube.

If the fallopian tube has ruptured, however, that portion of the fallopian tube will be removed along with the embryo.

After Treatment

Having an ectopic pregnancy can take an emotional toll, so a woman and her partner will likely need time to grieve the loss of the baby.

A woman who has experienced the trauma of surgery also requires time to heal physically.

Having a normal pregnancy following an ectopic pregnancy is possible.

But women who have had an ectopic pregnancy are at higher risk of having another one and should talk to their doctor about how and when it's safe to try conceiving again.